Nose Acne: Causes & Treatment

Acne is quite a common condition that plagues teenagers and adolescents. It is an annoying condition which significantly impacts the quality of life of people. Acne can severely dent the confidence levels and impact the psychosocial development of people. People try various over the counter medications, creams, and lotions available in the market which claim to be extremely effective for acne but with limited success. The variety of options that are provided for acne patients often at times confuse patients and physicians alike as to the choice of the best treatment. Acne is an inflammatory condition characterized by clogging of pores on the surface of the skin by dead skin cells, bacteria, and the natural oils produced by the sebaceous glands.[1]

The lesions seen with acne can be open or closed comedones, pustules, papules, or nodules which can cause significant scarring of the affected area and may even cause significant pigmentary changes. The primary areas where acne lesions can be seen include the face, neck, chest, nose, and the upper back. How severe is the acne can be determined by the area of distribution and the number of lesions that are visible along with whether there are any signs of scarring of the skin around the affected area.[1]

There are primarily two types of acne, namely acne vulgaris and acne rosacea. The symptoms of both of these forms of acne are quite similar and it is quite difficult to tell the difference between the two. However, both of these forms of acne are completely different from each other. While acne vulgaris results in the development of pustules, papules, and nodules on the skin surface, acne rosacea as the name suggests is a form of rosacea where the skin becomes unusually red and bumpy.[1]

Another way by which the difference between the two conditions can be analyzed is by looking at the characteristic of the lesions. In Acne Vulgaris, the pores are clogged which cause blackheads or open comedones, whiteheads or closed comedones, pus filled lesions, fluid filled cysts or pustules. At times, these lesions may be painful and tender to palpation. On the other hand, acne rosacea has characteristic feature of areas of the skin that are abnormally red and swollen. They usually begin in the cheek and then spread to other parts of the body, specifically the nose.[1]

There will also be accompanying inflammation and ultimately lesions develop on the erythematous area of the skin. This article gives a brief overview of the causes of Nose Acne and different ways to treat them.[1]

What Causes Nose Acne?

To better understand the cause of Nose Acne, it is important to understand the type of acne that is at play.

The causes for acne vulgaris and acne rosacea are different as these two are separate conditions. The primary cause of acne vulgaris on the nose is clogged pores that are present on the skin surface. These pores get clogged due to the sebum produced by the sebaceous glands that are present in the pores. This along with dead skin cells and the bacteria that are naturally present on the epidermis completely block the pores causing lesions as seen with acne to develop. The nose is most vulnerable due to the fact that the skin pores are larger here and the chances of them getting clogged are more.[2]

Additionally, acne on the nose at times is also indicative of an underlying medical condition. If acne lesions are seen on the nose tip then it signifies a problem with the digestive tract. Hormonal imbalances are indicated if the acne lesions are seen on the side of the nose. In extremely rare cases, acne lesions can also form inside the nose as a result of inflammation caused due to removal of hairs from inside the nose.[2]

Acne Rosacea on the other hand is caused due to enlargement of blood vessels that becomes visible. This enlargement causes inflammation which leads to redness of the skin and at times formation of blisters. It is a common misconception that acne rosacea is caused by acne. However this is not true even though it may cause lesions that are quite similar to that caused by acne vulgaris.[2]

How to Get Rid of Nose Acne?

Coming to treatment of Nose Acne, it depends on whether the individual has acne vulgaris or acne rosacea since the treatment approaches for these two conditions are different. Acne Vulgaris is further divided into two forms namely inflammatory and noninflammatory. Blackheads, whiteheads, small pimples all come under noninflammatory acne. They are effectively treated by using over the counter creams and lotions. These creams eliminate the bacteria clogging the skin pores and remove the other ingredients thus reopening the pores and getting rid of the lesions.[2]

The best creams and lotions to get rid of lesions on the nose caused by noninflammatory acne are the ones that contain salicylic acid. This acid removes the bacteria and dead skin cells that clog the skin pores. Salicylic acid is also an excellent Exfoliant and thus is extremely affective for Nose Acne. Additionally, Exfoliant like glycolic acid is also extremely effective in getting rid of Nose Acne. There is no need for any prescription medicines for treatment of noninflammatory acne of the nose.[2]

In cases of inflammatory acne, more aggressive treatments are required. The lesions are more like cysts or nodules. There will be surrounding swelling around the lesions. Over the counter medications in such cases are only useful if these lesions present infrequently. Otherwise, a consultation with a dermatologist is required for stronger medications. At times, using a warm washcloth over the lesions can expel the debris within the skin pores and unclog them thus getting rid of the nodules.[2]

In cases where the nodules are severe and unresponsive to standard over the counter approaches of treatment then the physician may prescribe antibiotics for temporary relief from nodules and pimples caused by inflammatory rosacea. It also helps in reducing inflammation. The physician will also give retinoids for maximum relief as it shrinks the sebaceous glands and squeezes the dead skin cells, bacteria, and natural oils from the pores.[2]

However, retinoids have significant side effect profile and should never be given to pregnant females. Thus it is recommended to weigh the risks versus benefits of retinoid with the physician before starting treatment.[2]

For treatment of acne rosacea, a consultation with a dermatologist is necessary as home remedies and over the counter products is seldom effective. For best effectiveness, the physician will prescribe brimonidine to decrease the erythema and inflammation. The mechanism of working of this medication is by constricting the blood vessels. If used diligently it may also result in fading away of the pimples.[2]

Additionally, the physician may also prescribe metronidazole for long term relief. Creams and lotions may also be prescribed for immediate relief of pimples caused by acne rosacea. If all these measures are ineffective then isotretinoin will be prescribed for treatment. Additionally, there are also certain alternative therapies that can also be effective in treating Nose Acne caused by rosacea.[2]

Some of these therapies include dermabrasion which works by removing excess skin cells that cause acne. Stress which plays a vital role in the development of acne should also be taken care of in a healthful manner with yoga, meditation, and other stress management techniques. Laser treatments have also shown good effectiveness in treating rosacea leading to acne lesions on the nose.[2]

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